Impact of guideline changes on adoption of hypofractionation and breast cancer patient characteristics in the randomized controlled HYPOSIB trial
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| Názov: | Impact of guideline changes on adoption of hypofractionation and breast cancer patient characteristics in the randomized controlled HYPOSIB trial |
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| Autori: | David Krug, Reinhard Vonthein, Andreas Schreiber, Alexander D. Boicev, Jörg Zimmer, Reinhold Laubach, Nicola Weidner, Stefan Dinges, Matthias Hipp, Ralf Schneider, Evelyn Weinstrauch, Thomas Martin, Juliane Hörner-Rieber, Denise Olbrich, Alicia Illen, Nicole Heßler, Inke R. König, Kathrin Dellas, Jürgen Dunst |
| Zdroj: | Strahlenther Onkol |
| Informácie o vydavateľovi: | Springer Science and Business Media LLC, 2020. |
| Rok vydania: | 2020 |
| Predmety: | 03 medical and health sciences, Logistic Models, 0302 clinical medicine, Humans, Original Article, Breast Neoplasms, Female, Radiation Dose Hypofractionation, Radiotherapy, Adjuvant, Dose Fractionation, Radiation, Female [MeSH], Radiotherapy, Adjuvant/methods [MeSH], Humans [MeSH], Breast cancer, Logistic Models [MeSH], Breast Neoplasms/radiotherapy [MeSH], Hypofractionation, Radiation Dose Hypofractionation [MeSH], Dose Fractionation, Radiation [MeSH], Radiotherapy, Breast Neoplasms/pathology [MeSH], Guideline implementation, 3. Good health |
| Popis: | Purpose Hypofractionated radiotherapy is the standard of care for adjuvant whole breast radiotherapy (RT). However, adoption has been slow. The indication for regional nodal irradiation has been expanded to include patients with 0–3 involved lymph nodes. We investigated the impact of the publication of the updated German S3 guidelines in 2017 on adoption of hypofractionation and enrollment of patients with lymph node involvement within a randomized controlled phase III trial. Methods In the experimental arm of the HYPOSIB trial (NCT02474641), hypofractionated RT with simultaneous integrated boost (SIB) was used. In the standard arm, RT could be given as hypofractionated RT with sequential boost (HFseq), normofractionated RT with sequential boost (NFseq), or normofractionated RT with SIB (NFSIB). The cutoff date for the updated German S3 guidelines was December 17, 2017. Temporal trends were analyzed by generalized linear regression models. Multiple logistic regression models were used to investigate the influence of time (prior to/after guideline) and setting (university hospital/other institutions) on the fractionation patterns. Results Enrollment of patients with involved lymph nodes was low throughout the trial. Adoption of HFseq increased over time and when using the guideline publication date as cutoff. Results of the multiple logistic regressions showed an interaction between time and setting. Furthermore, the use of HFseq was significantly more common in university hospitals. Conclusion The use of HFseq in the standard arm increased over the course of the HYPOSIB trial and after publication of the S3 guideline update. This was primarily driven by patients treated in university hospitals. Enrolment of patients with lymph node involvement was low throughout the trial. |
| Druh dokumentu: | Article Other literature type |
| Jazyk: | English |
| ISSN: | 1439-099X 0179-7158 |
| DOI: | 10.1007/s00066-020-01730-9 |
| Prístupová URL adresa: | https://link.springer.com/content/pdf/10.1007/s00066-020-01730-9.pdf https://pubmed.ncbi.nlm.nih.gov/33320286 https://pubmed.ncbi.nlm.nih.gov/33320286/ https://www.ncbi.nlm.nih.gov/pubmed/33320286 https://link.springer.com/article/10.1007/s00066-020-01730-9 https://link.springer.com/content/pdf/10.1007/s00066-020-01730-9.pdf https://portal.dnb.de/opac.htm?method=simpleSearch&cqlMode=true&query=idn%3D1225605598 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397631 https://repository.publisso.de/resource/frl:6443186 |
| Rights: | CC BY |
| Prístupové číslo: | edsair.doi.dedup.....344b1bc2f9bc9c80e02589f41da8eb59 |
| Databáza: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Purpose Hypofractionated radiotherapy is the standard of care for adjuvant whole breast radiotherapy (RT). However, adoption has been slow. The indication for regional nodal irradiation has been expanded to include patients with 0–3 involved lymph nodes. We investigated the impact of the publication of the updated German S3 guidelines in 2017 on adoption of hypofractionation and enrollment of patients with lymph node involvement within a randomized controlled phase III trial. Methods In the experimental arm of the HYPOSIB trial (NCT02474641), hypofractionated RT with simultaneous integrated boost (SIB) was used. In the standard arm, RT could be given as hypofractionated RT with sequential boost (HFseq), normofractionated RT with sequential boost (NFseq), or normofractionated RT with SIB (NFSIB). The cutoff date for the updated German S3 guidelines was December 17, 2017. Temporal trends were analyzed by generalized linear regression models. Multiple logistic regression models were used to investigate the influence of time (prior to/after guideline) and setting (university hospital/other institutions) on the fractionation patterns. Results Enrollment of patients with involved lymph nodes was low throughout the trial. Adoption of HFseq increased over time and when using the guideline publication date as cutoff. Results of the multiple logistic regressions showed an interaction between time and setting. Furthermore, the use of HFseq was significantly more common in university hospitals. Conclusion The use of HFseq in the standard arm increased over the course of the HYPOSIB trial and after publication of the S3 guideline update. This was primarily driven by patients treated in university hospitals. Enrolment of patients with lymph node involvement was low throughout the trial. |
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| ISSN: | 1439099X 01797158 |
| DOI: | 10.1007/s00066-020-01730-9 |